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Moraes SDQ, Paiva Neto FTD, Loch MR, Fermino RC, Rech CR. Characteristics and counseling strategies for physical activity used by primary health care professionals. CIENCIA & SAUDE COLETIVA 2024; 29:e00692023. [PMID: 38198320 DOI: 10.1590/1413-81232024291.00692023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 04/17/2023] [Indexed: 01/12/2024] Open
Abstract
This study aim to describe the characteristics and strategies of counseling for physical activity used by Primary Health Care (PHC) professionals. A survey was carried out with 587 (85.4% women) health professionals who work in PHC in Florianopolis, in the state of Santa Catarina, southern Brazil. Counseling carried out in the last 12 months was considered. Operational aspects related to counseling practices and strategies used for counseling were evaluated. The frequency of physical activity guidance was 86.2% (95%CI = 83.2-88.8%). Counseling was characterized as a brief practice, carried out in individual consultations, aimed at adults and the older adults and people with morbidities. The most used strategy was to guide users to participate in physical activity groups at the Health Center (89.5%) and in relation to the 5As method, giving some "advice" was the most used strategy (99.0%) and the least used. used was to follow strategies (22.6%). Counseling for physical activity has been based on a brief practice, carried out in individual consultations and focused on people with morbidities and on adults and the elderly. The strategies used do not seem to cover the full care of the advised users.
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Affiliation(s)
- Sheylane de Queiroz Moraes
- Programa de Pós-Graduação em Educação Física, Universidade Federal de Santa Catarina. Campus Universitário, Prédio Administrativo do Centro de Desportos, Trindade. 88040-900 Florianópolis SC Brasil.
| | | | - Mathias Roberto Loch
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual de Londrina. Londrina PR Brasil
| | - Rogério César Fermino
- Programa de Pós-Graduação em Educação Física, Universidade Federal Tecnológica do Paraná. Curitiba PR Brasil
| | - Cassiano Ricardo Rech
- Programa de Pós-Graduação em Educação Física, Universidade Federal de Santa Catarina. Campus Universitário, Prédio Administrativo do Centro de Desportos, Trindade. 88040-900 Florianópolis SC Brasil.
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Autocuidado para hipertensos. SCIENTIA MEDICA 2022. [DOI: 10.15448/1980-6108.2022.1.41928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objetivo: apresentar o desenvolvimento do material educativo intitulado “Autocuidado para Hipertensos: um guia para cuidar da sua saúde”.Métodos: este material foi desenvolvido com base nas orientações para construção de materiais de orientação para o cuidado em saúde, teve como ponto de partida o estudo multicêntrico: “Efetividade de uma estratégia NUtricional para controle PRESSórico em pacientes com hipertensão arterial sistêmica usuários do Sistema Único de Saúde: estudo NUPRESS”. Para a elaboração do material foi feito um levantamento bibliográfico. Em seguida, foi realizada a escrita dos temas abordados em forma de capítulos e, por último, foi montada a parte gráfica. Quando finalizado, o e-book foi enviado a 10 juízes que o avaliaram e validaram conforme a sua organização, estilo da escrita, aparência e apelo do material. Foram aceitas as sugestões dos juízes e realizadas as alterações. Resultados: os juízes (n=10), com média de idade de 43,7±17,6 anos e sendo 70% do sexo feminino, avaliaram em sua maioria, com concordância que o conteúdo do e-book possuía boa organização e aparência. Já os domínios de estilo de escrita e apelo foram os que apresentaram menor percentual de concordância entre os juízes, embora tenham obtido uma aprovação de 83,3% em cada dimensão. Conclusões: o e-book desenvolvido pode ser utilizado tanto por profissionais da saúde quanto por pessoas com hipertensão com o propósito de educação sobre a doença, saúde e autocuidado. O material tem linguagem objetiva e de fácil compreendimento, sem usar termos técnicos, além disso foram utilizados recursos gráficos para cativar e facilitar a leitura.
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Kunihiro S, da Silva Vernasque JR, da Silva C, dos Santos MF, Cremasco CP, Gabriel Filho LRA. Intersectoral Actions for the Promotion and Prevention of Obesity, Diabetes and Hypertension in Brazilian Cities: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13059. [PMID: 36293640 PMCID: PMC9602621 DOI: 10.3390/ijerph192013059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/19/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
This study showed the effectiveness of biomedical interventions in obesity, diabetes and hypertension (NCDs), but innovative and intersectoral elements in the fight against obesity, type 2 diabetes and hypertension were rare. BACKGROUND Is it possible to find effective and innovative actions to promote health and prevent NCDs in Brazilian municipalities? Can they be replicated? OBJECTIVE Our objectives were to identify innovative and effective intersectoral actions for promoting and preventing NCDs in Brazilian municipalities. METHODS This is a systematic review in an exploratory theoretical essay with a qualitative and quantitative approach. It is descriptive and analytical in terms of reporting findings and results. Inclusion and exclusion criteria favored health promotion work. Bias risk assessments was performed using the Cochrane GRADE and bias risk, with meta-analyses using RevMan and Iramuteq. RESULTS Meta-analysis of biometric markers resulted in -4.46 [95% IC; -5.42, -3.49], p = 0.00001, indicating a reduction in NCD risk rates. The textual meta-analysis revealed P(r) ≈ 83% (Reinert), meaning low connectivity between the 'halos'. CONCLUSIONS There is evidence of the effectiveness in interventions, but innovative and intersectoral elements to combat and prevent NCDs were barely seen. While evidence of intervention effectiveness was observed, innovative and intersectoral elements to combat and prevent NCDs were barely noticed.
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Affiliation(s)
- Stephen Kunihiro
- School of Sciences and Engineering, São Paulo State University (UNESP), Tupã 17602-673, Brazil
| | - Juliana Ribeiro da Silva Vernasque
- Faculty of Medical and Biological Sciences, São Paulo State University (Unesp), Botucatu 18618-687, Brazil
- Marília Medical School, FAMEMA, Marília 17519-030, Brazil
| | - Celso da Silva
- School of Sciences and Engineering, São Paulo State University (UNESP), Tupã 17602-673, Brazil
- Maurício de Nassau College—Dean’s Office, Maurício de Nassau University Center (UNINASSAU), Recife 52011-220, Brazil
- The Regional Council of Administration—CRA/SP, São Paulo 01427-001, Brazil
| | | | - Camila Pires Cremasco
- School of Sciences and Engineering, São Paulo State University (UNESP), Tupã 17602-673, Brazil
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Tavares MLDO, Montenegro LC, Beinner MA, Garcia-Vivar C, Pimenta AM. Fatores socioculturais que contribuem para a qualidade de vida de cuidadores familiares de adultos dependentes de cuidados crônicos. REME: REVISTA MINEIRA DE ENFERMAGEM 2022. [DOI: 10.35699/2316-9389.2022.38502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Objetivo: explorar os fatores socioculturais que contribuem para a qualidade de vida de cuidadores familiares de adultos dependentes de cuidados crônicos no Brasil. Método: estudo qualitativo realizado de outubro de 2016 a março de 2017 em Belo Horizonte, Minas Gerais, Brasil. Vinte e cinco cuidadores familiares de adultos dependentes de cuidados crônicos foram entrevistados por dois pesquisadores por meio de visitas domiciliares. Foi utilizado um roteiro com sete questões abertas relacionadas ao processo de cuidar. As entrevistas foram gravadas em áudio, transcritas e, posteriormente, analisadas por meio da análise de conteúdo. O COREQ foi utilizado para adequação da qualidade estrutural do manuscrito. Resultados: os participantes do estudo relataram diferentes fatores socioculturais que contribuem para sua qualidade de vida. Esses fatores foram categorizados em três categorias principais: O impacto dos construtos socioculturais no processo de cuidar; O autocuidado e suas nuances: velhos desafios para os cuidadores; e Estado e cuidadores: desafios e possibilidades. Conclusões: a qualidade de vida do cuidador é influenciada por suas características e condições socioculturais, apresentando relação com seu modo de viver e de se expressar, sendo, portanto, passível de mudanças. O desenvolvimento de políticas sociais e de saúde para famílias cuidadoras é urgente para a prevenção da sobrecarga familiar e para a promoção de famílias sustentáveis que convivem com doenças crônicas não transmissíveis.
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Schwartz J, Oh P, Perotto MB, Rhodes RE, Firth W, Bredin SSD, Gaytán-González A, Warburton DER. A Critical Review on New Approaches for Chronic Disease Prevention in Brazil and Canada: From Wholistic Dietary Guidelines to Physical Activity Security. Front Cardiovasc Med 2021; 8:730373. [PMID: 34527714 PMCID: PMC8435680 DOI: 10.3389/fcvm.2021.730373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/10/2021] [Indexed: 01/12/2023] Open
Abstract
In light of new evidence on the prevention of chronic diseases and the elevated rates of overweight and obesity in Brazil and Canada, this critical review aims to interpret and synthesize current aspects regarding dietary and physical activity initiatives in both countries and make future recommendations. The pioneering work presented in the last Brazilian dietary guidelines has been called a model that can be applied globally, given its conceptualization of healthy eating that translates easily to practical guidance. The new Canadian Food Guide has incorporated similar aspects, also putting the country as a leader in dietary guidance. With these new recommendations, citizens in both Brazil and Canada have access to impactful evidence-informed nutritional guidelines. Both documents propose eating patterns that focus not only on health benefits, such as chronic disease prevention, but also incorporate well-being concerning cultural, economic, sociodemographic, biological, and ecological dimensions. A similar approach is required for physical activity to allow individuals to have attainable health and life goals and thereby fully enjoy their lives, regardless of geographical location, health status, and socioeconomic condition, a concept recently described as physical activity security. The wholistic dietary guidelines from both countries represent a change in paradigm in public health. Likewise, national evidence-based policies are warranted to reduce disparities in physical activity, allowing healthier and more active lifestyles for everyone.
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Affiliation(s)
- Juliano Schwartz
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Paul Oh
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Maira B. Perotto
- West Toronto Diabetes Education Program, LAMP Community Health Centre, Toronto, ON, Canada
| | - Ryan E. Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Wanda Firth
- Hearts & Health in Motion Program, Nova Scotia Health, QEII Health Sciences Centre, Halifax, NS, Canada
| | - Shannon S. D. Bredin
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
| | - Alejandro Gaytán-González
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
- Institute of Applied Sciences for Physical Activity and Sport, University of Guadalajara, Guadalajara, Mexico
| | - Darren E. R. Warburton
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
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Dulgheroff PT, da Silva LS, Rinaldi AEM, Rezende LFM, Marques ES, Azeredo CM. Educational disparities in hypertension, diabetes, obesity and smoking in Brazil: a trend analysis of 578 977 adults from a national survey, 2007-2018. BMJ Open 2021; 11:e046154. [PMID: 34281920 PMCID: PMC8291309 DOI: 10.1136/bmjopen-2020-046154] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Our study aimed to assess social inequality trends for hypertension, diabetes mellitus, smoking and obesity from 2007 to 2018 in adults from Brazilian capitals. SETTING Data from the Surveillance of Risk and Protection Factors for Chronic Diseases by Telephone Survey study, a cross-sectional telephone survey, conducted annually from 2007 to 2018. PARTICIPANTS We used data from 578 977 Brazilian adults (≥18 years). DESIGN Cross-sectional surveys conducted annually from 2007 to 2018. PRIMARY OUTCOME MEASURES Participants responded to a questionnaire about medical diagnosis of hypertension and diabetes, smoking status, weight and height. Educational inequalities (0-3, 4-8, 9-11 and 12 or more years of study) by sex and skin colour were assessed trough absolute, Slope Index of Inequality (SII) and relative measures of inequality, Concentration Index and trends were tested by Prais-Winsten. RESULTS All outcomes were more prevalent in the least educated. The largest absolute educational inequality was observed for hypertension (SIItotal=-37.8 in 2018). During 2007-2018, the total educational disparity remained constant for hypertension, increased for diabetes and smoking, and decreased for obesity. Overall, inequality was higher among women and non-whites, compared with men and whites. We found a reduction in absolute inequality for hypertension among non-whites, an increase for diabetes in all strata, and an increase for smoking in women and non-whites. The relative inequality decreased in women and whites and increased for smoking in all strata, except among men. CONCLUSION The educational inequality reduced for obesity, remained constant for hypertension and increased for diabetes and smoking from 2007 to 2018 in Brazilian adults.
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Affiliation(s)
| | | | | | - Leandro F M Rezende
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina Preventiva, Sao Paulo, SP, Brazil
| | - Emanuele Souza Marques
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Alves KCG, Guimarães RA, de Souza MR, de Morais Neto OL. Performance of family health teams for tackling chronic diseases in a state of the Amazon. PLoS One 2020; 15:e0241765. [PMID: 33156831 PMCID: PMC7647065 DOI: 10.1371/journal.pone.0241765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 10/20/2020] [Indexed: 11/21/2022] Open
Abstract
The most common cause of death worldwide is noncommunicable diseases. A cross-sectional study was conducted to evaluate the adequacy of the work process among family health teams and compare differences in regional adequacy in the state of Tocantins, in the Amazonian Region, Brazil. Categorical principal components analysis was used, and scores of each principal component extracted in the analysis were compared among health regions in Tocantins. A post hoc analysis was performed to compare the heath region pairs. The adequacy of family health teams’ work process was evaluated with respect to the Strategic Action Plan to Tackle NCDs. The results showed that the family health teams performed actions according to the Strategic Action Plan to Tackle NCDs. However, overall, the adequacy percentages of these actions according to the axes of the Plan are very uneven in Tocantins, with large variations among health regions. The family health teams in the Bico do Papagaio (Region 1), Médio Norte Araguaia (Region 2), Cantão (Region 4) and Capim Dourado (Region 5) regions have adequacy percentages ≥ 50% with the Strategic Action Plan to Tackle NCDs, whereas all other regions have percentages <50%. Health teams perform surveillance actions, health promotion, and comprehensive care for NCDs in accordance with the guidelines of the Strategic Action Plan to Tackle NCDs. The challenge of NCDs in primary care requires a care model that is tailored to users’ needs and has the power to reduce premature mortality and its determinants.
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Affiliation(s)
| | - Rafael Alves Guimarães
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Marta Rovery de Souza
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil
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Ruiz AMP, Lima MG, Medina LDPB, Pinto RL, Barros MBDA, Filho ADAB. Can Meals Outside Homes Impact Sodium Intake? Curr Dev Nutr 2020; 4:nzaa091. [PMID: 32582874 PMCID: PMC7302511 DOI: 10.1093/cdn/nzaa091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/01/2020] [Accepted: 05/20/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The WHO currently recommends a daily sodium intake of 2 g and has established the goal of a 30% reduction in mean salt intake by 2025. OBJECTIVE We sought to estimate sodium intake in study participants according to the locations of where they consumed meals and their demographic and socioeconomic characteristics and practices related to salt consumption. METHODS A population-based, cross-sectional study was conducted with a sample of 2574 individuals aged ≥10 y who answered the 2015 Campinas-Brazil Nutrition Survey. Mean sodium intake was estimated using a 24-h recall log and associations with the independent variables were tested using generalized regression analysis stratified by age group. RESULTS Sodium intake was higher in male participants as well as adolescents and adults who reported eating ≥1 meal outside the home (6.07% and 7.06% increase, respectively). Per meal, sodium was consumed more outside the home at breakfast, during an afternoon snack, and at dinner among adolescents. No significant differences were found in the analysis by type of meal among the adults and seniors. CONCLUSIONS Sodium intake exceeded the WHO recommendation in all age groups analyzed. Having ≥1 meal outside the home was associated with greater sodium intake among adolescents and adults. Measures to regulate the food industry and dietary/nutritional education strategies targeting consumers are important to reducing the sodium intake of the population.
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Affiliation(s)
- Ana Maria Pita Ruiz
- Department of Collective Health, School of Medical Sciences, University of Campinas, Campinas 13083-970, SP, Brazil
| | - Margareth Guimarães Lima
- Department of Collective Health, School of Medical Sciences, University of Campinas, Campinas 13083-970, SP, Brazil
| | | | - Renata Luz Pinto
- Department of Collective Health, School of Medical Sciences, University of Campinas, Campinas 13083-970, SP, Brazil
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Debon R, Bellei EA, Biduski D, Volpi SS, Alves ALS, Portella MR, De Marchi ACB. Effects of using a mobile health application on the health conditions of patients with arterial hypertension: A pilot trial in the context of Brazil's Family Health Strategy. Sci Rep 2020; 10:6009. [PMID: 32265476 PMCID: PMC7138856 DOI: 10.1038/s41598-020-63057-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 03/23/2020] [Indexed: 12/19/2022] Open
Abstract
Brazil’s Family Health Strategy (FHS) leads public health policies and actions regarding community health, addressing arterial hypertension (AH) in primary care settings. In this scenario, the use of communication technologies becomes appropriate for the monitoring of patients with AH. To preliminary verify the intervention approach and the effects of using an m-Health application on the health conditions of patients with AH for a future study, we conducted a non-randomized, controlled, non-blind trial (N = 39), comparing the use of a mobile health app (m-Health) with conventional AH monitoring over 3 months. During the study, we promoted health information workshops to engage patients from both intervention and control groups. Pre and post-intervention, we compared measurements of systolic and diastolic blood pressure; food frequency questionnaire; Appraisal of Self-Care Agency Scale; blood tests of hemogram, creatinine, uric acid, sodium, potassium, lipid profile, and glycemia. Improvements were identified in both groups due to the workshops, including the reduction in total and non-HDL cholesterol, healthier consumption of salads and sugary drinks, and increased self-care scores. Exclusively in the intervention group, which used the m-Health app, there was a change in systolic and diastolic pressure towards more adequate levels. In addition, the intervention group had improved levels of glucose and HDL cholesterol and reduced consumption of ultra-processed foods. In conclusion, the use of an m-Health app had positive effects on the health conditions of patients with AH under treatment within FHS, especially when combined with health information. On the context of FHS, the use of technology is encouraging supporting better health conditions.
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Affiliation(s)
- Raquel Debon
- Graduate Program in Human Aging, School of Physical Education and Physiotherapy, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Ericles Andrei Bellei
- Graduate Program in Applied Computing, Institute of Exact Sciences and Geosciences, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil.
| | - Daiana Biduski
- Graduate Program in Applied Computing, Institute of Exact Sciences and Geosciences, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Simiane Salete Volpi
- Graduate Program in Human Aging, School of Physical Education and Physiotherapy, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Ana Luisa Sant'Anna Alves
- Graduate Program in Human Aging, School of Physical Education and Physiotherapy, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Marilene Rodrigues Portella
- Graduate Program in Human Aging, School of Physical Education and Physiotherapy, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Ana Carolina Bertoletti De Marchi
- Graduate Program in Human Aging, School of Physical Education and Physiotherapy, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil.,Graduate Program in Applied Computing, Institute of Exact Sciences and Geosciences, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
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Sá JDS, Garcia LF, Bernuci MP, Yamaguchi MU. Scientometrics on interventions used for adherence of hypertension and diabetes therapies. EINSTEIN-SAO PAULO 2019; 18:eAO4723. [PMID: 31851224 PMCID: PMC6905157 DOI: 10.31744/einstein_journal/2020ao4723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 06/18/2019] [Indexed: 01/15/2023] Open
Abstract
Objective To identify interventions aimed to improve adherence to medical and non-medical antihypertensive and antidiabetic therapy. Methods Scientometric study conducted in February and March 2018, based on data collected on PubMed ® and SciELO databases, using the following search terms: “interventions to improve adherence to diabetes therapy”, “interventions to improve adherence to hypertension therapy” and “interventions to improve adherence to therapy for hypertension and diabetes”. Results A total of 95 articles were selected. Scientific production increased as of 2009, with a higher number of studies published between 2015 and 2017. Most interventions described in literature were aimed at diabetic patients (46.31%). Face-to-face interventions were more common (46.31%), followed by telephone-based (31.58%) and digital (26.31%) interventions. North America stood out as the continent with the highest number of publications (68.42%), followed by Europe (14.74%). Most studies (63.16%) were based on a single type of intervention. Conclusion Traditional intervention methods were more widely used to promote adherence to antihypertensive and antidiabetic therapy; digital technology emerged as a trend in interventions aimed to improve hypertension and diabetes-related health behaviors.
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Alves KCG, Guimarães RA, de Souza MR, de Morais Neto OL. Evaluation of the primary care for chronic diseases in the high coverage context of the Family Health Strategy. BMC Health Serv Res 2019; 19:913. [PMID: 31783845 PMCID: PMC6884915 DOI: 10.1186/s12913-019-4737-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 11/12/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This cross-sectional study evaluated the adequacy of the Family Health Strategy for the primary care model for chronic noncommunicable diseases and the changes that occurred between the two cycles of external evaluations of the National Program for Improving Access and Quality of Primary Care, which took place in 2012 and 2014, in the higher coverage context of the Family Health Strategy of Brazil, in the state of Tocantins, Brazil. METHODS The data source contained information on the infrastructure of the 233 Primary Health Units and on the work process of 266 health teams. The Principal Component Analysis for Categorical Data technique and the McNemar chi-squared statistical test for comparing paired samples were used, and a significance level of 5% with a 95% Confidence Interval was used. RESULTS The analysis identified a low proportion of dispensing of medications for the treatment of chronic disease in both cycles. There was a significant increase in seasonal influenza vaccination, in the number of sterilization, procedure, dressings and inhalation rooms. There was a small but significant reduction in the materials for cervical cancer screening, although they are available in almost 90.0% of the PHUs. More than 70.0% of the health teams carried out additional health education activities, encouraged physical activity, registered schoolchildren with health needs for monitoring, evaluated user satisfaction and user referral. CONCLUSIONS The findings of this study highlighted the improvement of the structure of the Primary Health Units, but identified a low provision of medicines to treat chronic diseases. The health promotion was performed as the main work process tool of family health teams, but it was little focused on intersectoral actions and on actions with the population in the area or on the empowerment of users through self-management support for chronic diseases. Furthermore, it is critical that the Family Health Strategy in Tocantins be organized and focused on the care of chronic diseases to improve and adapt itself to a primary chronic care model.
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Affiliation(s)
- Kelly Cristina Gomes Alves
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil. .,Department of Medicine, Federal University of Tocantins, Palmas, Brazil.
| | - Rafael Alves Guimarães
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Marta Rovery de Souza
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil
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Peters DH, Peters MA, Wickramasinghe K, Osewe PL, Davidson PM. Asking the right question: implementation research to accelerate national non-communicable disease responses. BMJ 2019; 365:l1868. [PMID: 31110030 PMCID: PMC6526393 DOI: 10.1136/bmj.l1868] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Non-communicable disease programmes can be strengthened by systematically identifying implementation challenges and translating them into questions that can be answered through appropriate research, say David H Peters and colleagues
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Affiliation(s)
- David H Peters
- Johns Hopkins University Bloomberg School of Public Health, USA
| | | | - Kremlin Wickramasinghe
- World Health Organization European Office for Prevention and Control of NCDs, Russian Federation
| | | | - Patricia M Davidson
- Johns Hopkins University School of Nursing, Secretariat, World Health Organization Collaborating Centres of Nursing and Midwifery, USA
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Moreira MA, Silva LBD, Alvarenga LDA, Cândido APC. Perfil clínico, nutricional e sociodemográfico de usuários do Centro Estadual de Atenção Especializada (CEAE) de Juiz de Fora, Minas Gerais. HU REVISTA 2019. [DOI: 10.34019/1982-8047.2017.v43.2806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
As doenças crônicas não transmissíveis (DCNT) são doenças multifatoriais que se desenvolvem no decorrer da vida, são de longa duração e são as principais causas de morte no mundo. Para que os portadores de DCNT recebam um atendimento interdisciplinar e integral eficaz, torna-se necessário conhecer o perfil desses. Devido a isso, este estudo teve por objetivo avaliar o perfil clínico, nutricional e sociodemográfico de usuários do Centro Estadual de Atenção Especializada (CEAE) em Juiz de Fora, MG. Trata-se de um estudo transversal com 547 usuários atendidos pelo serviço de nutrição, de julho a dezembro de 2014, do CEAE. Utilizou-se o software SPSS (23.0). Calculou-se medidas de frequência percentual e de tendência central. Aplicou-se teste de normalidade Kolmogorov-Smirnov. Para comparação entre sexos, utilizou-se Teste T e teste Mann-Whitney. Utilizou-se o teste Qui-quadrado para avaliação da diferença de risco entre as categorias, quantificadas pelo odds ratio e intervalo de confiança. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa Humana da Universidade Federal de Juiz de Fora (1.384.797). A média de idade foi de 61 ± 14 anos, com maior prevalência de mulheres e indivíduos com baixa escolaridade e baixa renda familiar. O sexo feminino apresentou chance 1,97 vezes maior de excesso de peso (p = 0,01) e chance de 7,88 vezes maior de risco referente à circunferência da cintura aumentada (p < 0,001). Idosos apresentaram uma probabilidade 43% menor de excesso de peso que o adulto. Conclui-se que este estudo, por traçar o perfil de usuários da atenção secundária, contribui para o desenvolvimento de políticas públicas voltadas a este público, para que recebam um atendimento holístico com qualidade.
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Bahia LR, da Rosa MQM, Araujo DV, Correia MG, dos Rosa RDS, Duncan BB, Toscano CM. Economic burden of diabetes in Brazil in 2014. Diabetol Metab Syndr 2019; 11:54. [PMID: 31303899 PMCID: PMC6604164 DOI: 10.1186/s13098-019-0448-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 06/24/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Diabetes and its complications produce significant clinical, economic and social impact. The knowledge of the costs of diabetes generates subsidies to maintain the financial sustainability of public health and social security systems, guiding research and health care priorities. AIMS The aim of this study was to estimate the economic burden of diabetes in Brazilian adults in 2014, considering the perspectives of the public health care system and the society. METHODS A prevalence-based approach was used to estimate the annual health resource utilization and costs attributable to diabetes and related conditions. The healthcare system perspective considered direct medical costs related to outpatient and hospitalization costs. The societal perspective considered non-medical (transportation and dietary products) and indirect costs (productivity loss, disability, and premature retirement). Outpatient costs included medicines, health professional visits, exams, home glucose monitoring, ophthalmic procedures, and costs related to end stage renal disease. The costs of hospitalization attributed to diabetes related conditions were estimated using attributable risk methodology. Costs were estimated in Brazilian currency, and then converted to international dollars (2014). RESULTS Based on a national self-reported prevalence of 6.2%, the total cost of diabetes in 2014 was Int$ 15.67 billion, including Int$ 6.89 billion in direct medical costs (44%), Int$ 3.69 billion in non-medical costs (23.6%) and Int$ 5.07 billion in indirect costs (32.4%). Outpatient costs summed Int$ 6.62 billion and the costs of 314,334 hospitalizations attributed to diabetes and related conditions was Int$ 264.9 million. Most hospitalizations were due to cardiovascular diseases (47.9%), followed by diabetes itself (18%), and renal diseases (13.6%). Diet and transportation costs were estimated at Int$ 3.2 billion and Int$ 462.3 million, respectively. CONCLUSIONS Our results showed a substantial economic burden of diabetes in Brazil, and most likely are underrated as they are based on an underestimated prevalence of diabetes. Healthcare policies aiming at diabetes prevention and control are urgently sought.
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Affiliation(s)
- Luciana Ribeiro Bahia
- Internal Medicine Department, Institute for Health Technology Assessment, State University of Rio de Janeiro, Boulevard 28 de Setembro, 77-Vila Isabel, Rio de Janeiro, RJ 20551-030 Brazil
| | - Michelle Quarti Machado da Rosa
- Internal Medicine Department, Institute for Health Technology Assessment, State University of Rio de Janeiro, Boulevard 28 de Setembro, 77-Vila Isabel, Rio de Janeiro, RJ 20551-030 Brazil
| | - Denizar Vianna Araujo
- Internal Medicine Department, Institute for Health Technology Assessment, State University of Rio de Janeiro, Boulevard 28 de Setembro, 77-Vila Isabel, Rio de Janeiro, RJ 20551-030 Brazil
| | - Marcelo Goulart Correia
- Biostatistics and Bioinformatics Department, National Institute of Cardiology, Rio de Janeiro, Brazil
| | | | - Bruce Bartholow Duncan
- Graduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Cristiana Maria Toscano
- Collective Health Department, Institute for Health Technology Assessment, Federal University of Goiânia, Goiânia, Brazil
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Silva LB, Soares SM, Silva PAB, Santos JFG, Miranda LCV, Santos RM. Assessment of the quality of primary care for the elderly according to the Chronic Care Model. Rev Lat Am Enfermagem 2018; 26:e2987. [PMID: 29538582 PMCID: PMC5863273 DOI: 10.1590/1518-8345.2331.2987] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 11/07/2017] [Indexed: 12/07/2022] Open
Abstract
OBJECTIVE to evaluate the quality of care provided to older people with diabetes mellitus and/or hypertension in the Primary Health Care (PHC) according to the Chronic Care Model (CCM) and identify associations with care outcomes. METHOD cross-sectional study involving 105 older people with diabetes mellitus and/or hypertension. The Patient Assessment of Chronic Illness Care (PACIC) questionnaire was used to evaluate the quality of care. The total score was compared with care outcomes that included biochemical parameters, body mass index, pressure levels and quality of life. Data analysis was based on descriptive statistics and multiple logistic regression. RESULTS there was a predominance of females and a median age of 72 years. The median PACIC score was 1.55 (IQ 1.30-2.20). Among the PACIC dimensions, the "delivery system design/decision support" was the one that presented the best result. There was no statistical difference between the medians of the overall PACIC score and individual care outcomes. However, when the quality of life and health satisfaction were simultaneously evaluated, a statistical difference between the medians was observed. CONCLUSION the low PACIC scores found indicate that chronic care according to the CCM in the PHC seems still to fall short of its assumptions.
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Affiliation(s)
- Líliam Barbosa Silva
- Doctoral student, Escola de Enfermagem, Universidade Federal de Minas
Gerais, Belo Horizonte, MG, Brazil. Scholarship holder at Coordenação de Aperfeiçoamento
Pessoal de Nível Superior (CAPES), Brazil
| | - Sônia Maria Soares
- PhD, Associated Professor, Escola de Enfermagem, Universidade Federal
de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | | | - Raquel Melgaço Santos
- Undergraduate student in Nursing, Escola de Enfermagem, Universidade
Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Hespanhol LC, Barboza SD, van Mechelen W, Verhagen E. Measuring sports injuries on the pitch: a guide to use in practice. Braz J Phys Ther 2015; 19:369-80. [PMID: 26537807 PMCID: PMC4647148 DOI: 10.1590/bjpt-rbf.2014.0110] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 05/12/2015] [Accepted: 05/25/2015] [Indexed: 12/22/2022] Open
Abstract
Sports participation is a major ally for the promotion of physical activity. However, sports injuries are important adverse effects of sports participation and should be monitored in sports populations. The purpose of this paper is to review the basic concepts of injury monitoring and discuss the implementation of these concepts in practice. The aspects discussed are: (1) sports injury definition; (2) classification of sports injuries; (3) population at risk, prevalence, and incidence; (4) severity measures; (5) economic costs; (6) systems developed to monitor sports injuries; and (7) online technology. Only with reliable monitoring systems applied in a continuous and long-term manner will it be possible to identify the burden of injuries, to identify the possible cases at an early stage, to implement early interventions, and to generate data for sports injury prevention. The implementation of sports injuries monitoring systems in practice is strongly recommended.
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Affiliation(s)
- Luiz C. Hespanhol
- Department of Public & Occupational Health, EMGO+ Institute for
Health and Care Research, VU University Medical Center, Amsterdam, The
Netherlands
| | - Saulo D. Barboza
- Department of Public & Occupational Health, EMGO+ Institute for
Health and Care Research, VU University Medical Center, Amsterdam, The
Netherlands
| | - Willem van Mechelen
- Department of Public & Occupational Health, EMGO+ Institute for
Health and Care Research, VU University Medical Center, Amsterdam, The
Netherlands
| | - Evert Verhagen
- Department of Public & Occupational Health, EMGO+ Institute for
Health and Care Research, VU University Medical Center, Amsterdam, The
Netherlands
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